tbuckley/cabot-search huggingface dataset:
Opportunistic cervical cancer screening for elderly women without standardized screening.
Authors: Kemin Li, Rutie Yin
Journal: Journal of Clinical Oncology (2022)

e17511 Background: To explore the important of the opportunistic cervical cancer screening for elderly women without standardized screening and the best opportunistic screening strategy. Methods: The participants were elderly women over the age of 65 without being undergone standardized cervical cancer screening from June 2017 to June 2021. All participants were undergone an opportunistic cervical cancer screening. High-risk HPV distribution was analyzed, and we would analysis the accuracy of different screening methods (only cytology, only HPV, HPV +cytology triage, and non-HPV 16/18 +cytology triage or HPV 16/18) for CINII+. Results: A total of 848 elderly women with high-risk HPV infection were included. There were 325 (38.3%) CINII+ patients and 145 (17.1%) invasive cancer patients. The top five HPV subtypes are HPV16, HPV52, HPV58, HPV53 and HPV56, and the infection rates are 31.4%, 21.9%, 19.7%, 11.6%, and 11.6%, respectively. The area under the ROC curve of five screening strategies was 0.715(0.681, 0.750) (ASCUS+), 0.498(0.458, 0.538), 0.623(0.584, 0.663), 0.714(0.680, 0.748) (ASCUS+), and 0.698(0.664, 0.733) (ASCUS+). Conclusions: Elderly women without being undergone standardized cervical cancer screening should be given a chance to be screened for cervical cancer, and the standardized screening program is suitable for elderly women.
GCT-15. Multi-institutional analysis and literature review of central nervous system germ cell tumors in patients with Down syndrome
Authors: Micah K Harris, Joseph R Stanek, Richard T Graham, Andréa M Cappellano, Ashley S Margol, George Michaiel, John R Crawford, Kevin X Liu, Shannon M MacDonald, Mohamed S Abdelbaki
Journal: Neuro-Oncology (2022)

Abstract BACKGROUND: A standard-of-care has not been established for the management of patients with Down syndrome (DS) who develop primary central nervous system (CNS) germ cell tumors (GCTs) – the most common CNS neoplasm in DS – despite being more susceptible to treatment-related adverse events. METHODS: Data from large academic institutions were collected and a comprehensive review of the medical literature was conducted. RESULTS: Ten patients from six institutions (five USA, one Brazil) were reviewed. Additionally, thirty-one patients were identified in the literature from 1975-2021. Of the 41 total patients, mean age was ten years (range, birth to 35 years); males were predominant (61%). Basal ganglia were the most common tumor location (n=12; 29%), followed by posterior fossa (n=7; 17%). Sixteen patients had non-germinomatous germ cell tumors (NGGCTs) (39%), 14 had pure germinomas (34%), and eight had teratomas (20%); histology was unreported for two (5%). Nine patients (22%) experienced disease relapse, of which four died from tumor progression (one germinoma versus three teratoma). Fifteen patients (37%) experienced treatment-related complications - seven died (four germinoma versus three NGGCT). Of the germinoma patients, two died from chemotherapy-related sepsis, one from post-surgery cardiopulmonary failure, and one from Moyamoya following radiation-therapy (RT) only. Of the NGGCT patients, one died from chemotherapy-related sepsis, one from post-surgical infection, and one from pneumonia following surgery/chemotherapy/RT. Three-year overall survival (OS) was 66% for all histological types - 62% germinoma, 79% for NGGCT, and 53% for teratoma. Three-year OS for patients who received RT or chemotherapy was 71% and 75% respectively. Twenty-seven patients remain alive at latest follow-up (mean follow-up from diagnosis: 46.8 months). CONCLUSIONS: Patients with DS treated for CNS GCTs are at an increased risk of treatment-related adverse events. A different therapeutic approach may need to be considered for this patient population to mitigate treatment-related complications and long-term neurocognitive sequelae.
Evaluating the quality of clinical evidence in gastrointestinal cancers PubMed searches: How relevant are the results?
Authors: Ivy Riano, Hugo Pomares-Millan, Chet W. Hammill, Nikolaos Trikalinos
Journal: Journal of Clinical Oncology (2022)

11037 Background: Bibliographic repositories have become increasingly important as clinical evidence is more accessible on the internet. Often, oncologists rely on published literature to guide patient care. However, with the proliferation of journals and increasing number of peer reviewed papers, current search strategies have the potential to retrieve large numbers of irrelevant or misleading articles. Moreover, access to current best evidence may require paid subscriptions. Here, we assessed the quality of retrieved medical literature pertaining to treatment of gastrointestinal cancers using the PubMed database. Methods: We interrogated 6 focused-therapy questions in 3 categories: medical oncology (MedOnc), surgical oncology (SurgOnc), and alternative medicine (AltMed). We extracted journal metrics of the first two pages (40 results) from each search. We defined the composite outcome “relevant result” as the product of removing results from 1) predatory journals (Beall’s list), 2) non-English language, and 3) no free access publications. As a sensitivity analysis, we defined 2007 as a cutoff for “relevant” publications and Impact Factor (IF) &gt; 3 or H-index &gt; 50. Results: Two hundred and forty results were retrieved (80 per search type). Forty-eight percent of the journals were European (n = 115), 40% US-based (n = 96), and 94% were in English (n = 225). Most journals (n = 170; 70.8%) had an IF between 1-10, followed by ̃21% with an IF &gt; 10 (n = 51); yet ̃45% (n = 107) were in the Clarivate Analytics top quartile. Sixty percent (n = 139) of articles were free to access. The articles had a median H-index of 117 [IR 59, 168]. When modelling the multivariate association with “relevant result”, year of publication after 2007 had an OR = 1.07 (95% CI = 1.01-1.14; p&lt; 0.02) and availability through GOLD Open Access by Clarivate Analytics had an OR = 1.09 (95% CI = 1.03-1.15; p&lt; 0.0008). MedOnc retrieved more papers published in journals with IF &gt; 10 (n = 31; 38.8%) than SurgOnc searches (n = 12; 15%; p&lt; 0.001). Only the AltMed searches included non-peer reviewed publications (n = 4; 5%) and 4 results were from “predatory journals”, all in MedOnc. Conclusions: Articles had a 7% higher chance of being considered a “relevant result” if they were published after 2007 and a 9% higher chance if available under GOLD Open Access. Publications identified as “relevant results” with an IF or H-index above the established cutoffs, had a 6% higher chance to be in the top 40 PubMed search results. In the sensitivity analysis the results remain virtually unchanged. Importantly, nearly 40% of papers indexed in PubMed do not have free full-text articles, making them unavailable to oncologists without access to a medical library or paid subscription. These results highlight the imperative to deliver relevant, freely accessible information that can impact the care of the cancer patients.
Feasibility study of integrated ePROs in routine care during radiation therapy for head and neck cancer.
Authors: Jed Abraham Katzel, Stephen K. VanDenEeden, Raymond Liu, Amethyst D. Leimpeter, Cecilia B. Briones, Dionne L. Lewis, Nancy M. Lee-Enriquez, Jennifer M. Yan, Andrea Altschuler, Amy M. Gillis, Deep Patel, Milan Dilip Patel, Marcy Ann Kaufman, Jun Shan, Ethan Basch
Journal: Journal of Clinical Oncology (2022)

e13612 Background: Use of electronic Patient Reported Outcomes (ePRO) tools in the routine care of cancer patients remains challenging despite data showing that they can improve resource utilization and patient outcomes. Patients with head and neck cancer during intensive therapy with radiation therapy (RT) may particularly benefit from interventions focused on early symptom management. Methods: 34 patients with head and neck cancer were enrolled in an implementation study and received ePROs integrated within the electronic medical record (EMR) weekly during radiation therapy (RT) within a large integrated health care delivery system. ePROs consisted of the FACT G7 and FACT-HN. After completion of each survey on the patient portal, a radiation oncology RN documented any abnormal findings and subsequent interventions using a standardized format within the EMR. If patients did not have access to the patient portal or had language barriers, they could complete ePROs with a translator by phone or video. Results: Between January and December of 2021, 34 patients with head and neck cancer receiving curative RT were enrolled. The median age 65 years (range 46-84). 74% of patients were male. 59% were white, 26% Asian/PI, 5% Black, and 5% Hispanic. The most common primary cancer sites were: oropharynx (32%), nasopharynx (24%), larynx (18%), oral cavity (9%). 65% of patients received concurrent chemotherapy with RT and 35% received RT alone. 97.4% of patients had access to the online portal. The total number of surveys completed was 194 with a median of 7 per patient (range 1-8). There was a total of 887 abnormal findings reported and 887 documented and corresponding interventions resulting in a 100% intervention rate. Over the course of RT the mean number of abnormal findings increased from 2.26 at baseline (n = 34) to 6.27 at week 7 (n = 24), P &lt; 0.0001. Hospitalizations and Emergency Department (ED) visit data were collected during the study and up to 30 days from last day of RT. There was a total of 2 hospitalizations and 8 ED visits. Conclusions: ePROs integrated within the patient portal and EMR are feasible during RT for patients with head and neck cancer within a large integrated health care system. The use of ePROs integrated within the patient portal and EMR can lead to a high rate of intervention. The increasing number of abnormal findings on ePRO during intensive treatment for head and neck cancer is consistent with known patterns of toxicity and confirm the value of studying methods for improving quality of life in this patient population.[Table: see text]
Combined modality therapy for early-stage Hodgkin lymphoma in the PET era: A real-world study.
Authors: Karan Chohan, Jason R. Young, Scott Lester, Muhamad Alhaj Moustafa, Allison Claire Rosenthal, Han W. Tun, Bradford Hoppe, Patrick B. Johnston, Ivana N. M. Micallef, Thomas Matthew Habermann, Stephen M. Ansell
Journal: Journal of Clinical Oncology (2022)

e19532 Background: The traditional approach to the treatment of early-stage classical Hodgkin lymphoma (cHL) has been combined modality therapy (CMT) with both chemotherapy and radiotherapy (RT). CMT has shown improved disease control, but RT can lead to long-term adverse effects, including secondary malignancies and cardiac toxicity. Multiple clinical trials have assessed treatment de-escalation strategies to chemotherapy-alone regimens, but results are conflicting. We aimed to assess the real-world implications of these trials by comparing patient outcomes based upon treatment with CMT or chemotherapy-alone. Furthermore, we proposed to assess differences in treatment outcomes stratified by disease bulk, favorable/unfavorable disease, and PET2 response. Methods: We conducted a retrospective, multi-center cohort study of consecutive adult patients with early-stage (stage IA-IIB) cHL treated between January 2010-December 2020. Baseline characteristics, treatment modality, and outcomes were abstracted by chart review. Available PET2 scans (n=110) were independently reviewed by a blinded nuclear radiologist. Deauville score (DS) ≥4 was characterized as positive (+), and DS≤3 negative (-). All analysis was conducted using intention-to-treat principles based upon the initial treatment plan (CMT or chemotherapy-alone). Results: In 125 patients [58% male, median age 34 (range, 18-78)] with early-stage cHL, CMT was intended in 63 (50%) patients, with chemotherapy-alone in 62 (50%). Bulky disease was observed in 43 (34%), unfavorable disease in 81 (65%), and 15 (14%) were found to be PET2+. With median follow-up of 59.8 months (95%CI, 48.6 to 71.0), 5 (4%) deaths occurred, and 17 (14%) patients had relapsed/refractory disease. No significant differences in overall survival (OS) were seen based upon treatment intention. However, there was substantially reduced progression-free survival (PFS) (Table) with chemotherapy-alone in the whole cohort, and also in those with bulky, unfavorable, and PET2+ disease. No significant PFS differences were seen based upon treatment intention for patients with non-bulky, favorable, or PET2- disease. Conclusions: Based on our real-world experience, CMT appears particularly beneficial for patients with bulky disease, unfavorable prognostic factors, and PET2+ disease. However, while recent trials showed a benefit of CMT in non-bulky, favorable and PET2- patients, chemotherapy-alone may be comparable for these patients in actual clinical practice.[Table: see text]
Nasal-Type NK/T-Cell Lymphoma Involvement of the Vocal Cord on FDG PET/CT
Authors: Mingxing Huang, Rang Wang, Guohua Shen, Rong Tian
Journal: Clinical Nuclear Medicine (2022)

Abstract Nasal-type extranodal natural killer/T-cell lymphoma (ENKTL) rarely involves the vocal cord. Herein, we present a case of an ENKTL patient with vocal cord involvement revealed by FDG PET/CT. Nasopharyngoscopy showed a neoplasm in the larynx, which was eventually confirmed as ENKTL by immunohistochemical results. PET/CT was subsequently performed for staging, and intense FDG uptake in the left side of vocal cord suggested ENKTL involvement.
Diagnostic accuracy of preoperative lymph node staging of bladder cancer according to different lymph node locations: A multicenter cohort from the European Association of Urology – Young Academic Urologists
Authors: C. Lonati, L. Mordasini, L. Afferi, O. De Cobelli, E. Di Trapani, A. Necchi, A. Briganti, F. Montorsi, C. Simeone, S. Zamboni, G. Simone, R.J. Karnes, G. Marra, F. Soria, P. Gontero, S.F. Shariat, K. Hendrickesn, M. Rink, C. Poyet, R. Carando, W. Krajewski, P. Baumeister, A. Mattei, M. Moschini
Journal: European Urology (2022)
MEDB-61. Genetic alterations of<i>TP53</i> and<i>OTX2</i> indicate increased risk of relapse in WNT medulloblastomas
Authors: Tobias Goschzik, Martin Mynarek, Evelyn Dörner, Stefan Aretz, Stefan Rutkowski, Torsten Pietsch
Journal: Neuro-Oncology (2022)

Abstract PURPOSE: This genetic analysis of WNT-activated medulloblastomas (WNT-MBs) aimed to re-evaluate the prognostic impact of TP53 mutations and to identify specific chromosomal aberrations as possible prognostic markers in a retrospective cohort of patients treated according to the protocols of the HIT medulloblastoma studies. PATIENTS AND METHODS: In a cohort of 191 patients with WNT-MBs, mutations in CTNNB1, APC, and TP53 were analyzed by Sanger and/or NGS panel sequencing. Chromosomal copy number aberrations (CNAs) were assessed by high-resolution, genome-wide molecular inversion probe technology (MIP), SNP6 array, and/or 850k methylation bead-array hybridization. Complete clinical data were available from 120 patients. RESULTS: Patients with WNT-MBs had a female predominance (1.4:1) and a median age of 13 years (range 3-69 years). CTNNB1 mutations were present in 92.2% of the samples, APC mutations in 6.8%. One CTNNB1 wildtype tumor gained WNT-activation due to a homozygous deletion of FBXW7. Monosomy 6 was present in 78.6%, but more frequent in children compared to adults. 16.1% of the tumor samples showed TP53 mutations, of those 60% with nuclear positivity for the p53 protein. A loss of heterozygosity at the TP53 locus on chromosome 17p13.1 was found in 40.7% (11/27) of TP53 mutant tumor samples and in 18.5% of the whole cohort (24/130 cases). Patients with tumors harboring TP53 mutations showed significant worse progression-free survival (PFS; p=0.001), but not overall survival (OS) and were enriched for chromosomes 17p (p=0.001), 10, and 13 losses. Gains of the OTX2 locus on chromosome 14q were also associated with poor PFS and OS (p=0.017 resp. p=0.006). Multivariate Cox regression analysis identified both genetic alterations as independent prognostic markers for PFS and OS. CONCLUSION: For ongoing and future de-escalation trials for patients with WNT medulloblastomas, we recommend to exclude patients with tumors carrying TP53 mutations or OTX2 gains.
Bendamustine is safe and effective for lymphodepletion before tisagenlecleucel in patients with refractory or relapsed large B-cell lymphomas
Authors: G. Ghilardi, E.A. Chong, J. Svoboda, P. Wohlfarth, S.D. Nasta, S. Williamson, J.D. Landsburg, J.N. Gerson, S.K. Barta, R. Pajarillo, J. Myers, A.I. Chen, L. Schachter, R. Yelton, H.J. Ballard, A. Hodges Dwinal, S. Gier, D. Victoriano, E. Weber, E. Napier, A. Garfall, D.L. Porter, U. Jäger, R.T. Maziarz, M. Ruella, S.J. Schuster
Journal: Annals of Oncology (2022)
Robot-assisted radical prostatectomy feasibility and optimal setting with a novel robotic platform
Authors: L. Sarchi, C.A. Bravi, A. Mottaran, M. Paciotti, P. Piazza, R. Farinha, F. Gonzalez Meza, M.A. Corsetti, C. Sinatti, S. Puliatti, R. De Groote, A. Mottrie
Journal: European Urology (2022)
Epcoritamab (epco) with gemcitabine + oxaliplatin (GemOx) in patients (pts) with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) ineligible for autologous stem cell transplant (ASCT) induces high response rate even in pts failing CAR T therapy.
Authors: Joshua Brody, Bjorn E. Wahlin, Tycel Jovelle Phillips, Régis Costello, Pieternella Lugtenburg, Raul Cordoba, Liwei Wang, Jun Wu, Brian Elliott, Aqeel Abbas, Judit Jørgensen
Journal: Journal of Clinical Oncology (2022)

7527 Background: Pts with R/R DLBCL who fail or are ineligible for ASCT have very poor outcomes with standard palliative chemotherapy. Rituximab + GemOx had a complete response rate of 33% (Cazelles et al, Leuk Lymphoma 2021); novel approaches are needed. Epco is a subcutaneously administered bispecific antibody targeting CD3 on T cells and CD20 on B cells. In the EPCORE NHL-1 dose-escalation trial, epco had manageable safety and antitumor activity in heavily pretreated B-cell NHL including DLBCL. EPCORE NHL-2 is a phase 1/2 trial evaluating epco + standard B-cell NHL therapies; shown here are results from arm 5 (NCT04663347). Methods: Adults with R/R CD20 + DLBCL who failed or were ineligible for ASCT received epco (QW, cycle [C] 1–3; Q2W, C4–9; Q4W, C≥10) and GemOx (Q2W, C1–4) until disease progression or unacceptable toxicity (28 d/C). Step-up epco dosing and prophylactic corticosteroids were required in C1 to mitigate CRS. Response was assessed by PET-CT per Lugano 2014 criteria. Results: As of Dec 1, 2021, 27 pts (median age, 71 y; range, 47–87 y) had received epco + GemOx (epco 24 mg, n=3; 48 mg, n=24). Most were stage IV (56%), primary refractory (56%), and refractory to last therapy (70%). Median number of prior therapies was 2 (range, 1–13). Median follow-up was 6.0 mo (range, 1.0–11.1), with treatment (Tx) ongoing in 16 pts (59%). The most common Tx-emergent AEs were CRS (70%), thrombocytopenia (70%), neutropenia (56%), anemia (52%), and infections (52%). CRS events were all grade (G) 1/2, with most cases occurring in C1; all cases resolved. One pt had ICANS (G3); 1 pt had tumor lysis syndrome (G3). Six pts (22%) had G5 AEs; investigator could not rule out contribution of epco in 2 pts: small bowel perforation in pt (72 y) with transformed DLBCL and extensive gastrointestinal involvement (had complete metabolic response [CMR]); acute hepatitis/multiorgan failure in pt (68 y) with transformed DLBCL and liver involvement (had CMR). Of 4 pts with fatal AEs unrelated to epcoritamab by investigator, 2 (87 y) had primary refractory disease and 2 (74 y) had multiple comorbidities. Response is shown in the Table. At the time of data cut, 65% of responders remained in response with the longest duration of response 6.9 mo. All 3 pts with prior CAR T remained on Tx and in response (2 CMR and 1 partial metabolic response [PMR]). Conclusions: When considering individual safety profiles of epco or GemOx, no unexpected safety findings were observed for epco + GemOx. In this R/R population with high unmet need, these initial data are encouraging and warrant further clinical evaluation. Clinical trial information: NCT04663347. [Table: see text]
Demographic disparities in genomic data and clinical trials for multiple myeloma.
Authors: Nidhi Aggarwal, Pankaj Kumar Ahluwalia, Ravindra B. Kolhe, Jorge E. Cortes
Journal: Journal of Clinical Oncology (2022)

8043 Background: There are considerable outcome disparities among patients with multiple myeloma (MM). African-Americans have higher risk of developing MM, earlier age at diagnosis, and higher mortality compared to Whites. While outcomes have multifactorial socioeconomic etiologies, race and ethnicity (R&amp;E) correlate with genomic ancestry, and any role of genetics should be explored. This requires equitable representation in biological databases like The Cancer Genome Atlas (TCGA). Here, we characterize disparities in MM cases of TCGA and clinical trials (CT). Methods: MM incidence was obtained from North American Association of Central Cancer Registries (NAACCR) for R&amp;E, sex and age ( &lt; 50, 50-64, 65+ years). Race includes White, Black, and Asian, along with Hispanic ethnicity, as TCGA MM is limited to these groups. Genes with oncogenic potential and &gt; 5% mutation were stratified by R&amp;E and age. TCGA MM cases are from USA, Canada, Italy, and Spain. On ClinicalTrials.gov, completed MM CT limited to these countries were identified. Student’s t-test and chi-square test were used to analyze disparities and gene mutations. Kaplan-Meier curve was generated to evaluate survival. Results: TCGA MM representation is in Table, calculated as (demographic TCGA cases divided by total TCGA cases) divided by (demographic incidence divided by total incidence). Race was not reported in 20% of TCGA, 4% of CT, and 3% of NAACCR. Of cases reporting R&amp;E, Hispanics are underrepresented by 26% in TCGA and 47% in CT relative to incidence, Blacks by 22% in TCGA and 41% in CT, and Asians by 40% in TCGA and 10% in CT. Whites are overrepresented, by 8% in TCGA and 7% in CT. More men are in TCGA than women, in all R&amp;E. Less than 25% of patients age &lt; 50 relative to incidence are in TCGA, in all R&amp;E. BCL7A is mutated more in Blacks age &lt; 50 (n = 20, 50%) than Whites (n = 39, 10%) (p &lt; 0.01). FAT4 is mutated in Whites age 65+ (n = 31, 10%) but not Blacks. In all ages, KRAS is mutated more in Blacks than Whites (31-35% vs. 20-25%, p &lt; 0.05). Black patients have lower survival than Whites (p &lt; 0.02). In patients age 65+, KRAS mutation is associated with 10% lower 4.5-year survival. Conclusions: Substantial disparities in Black, Hispanic, women, and age representation exist for MM cases in TCGA and CT. This stratification by R&amp;E and age offers new insight on BCL7A, FAT4, and KRAS mutation in MM. Mutation status is associated with survival in older patients. Equitable demographic representation should be pursued to improve quality of available data and access to medical resources for all populations. [Table: see text]